Improving the NHS… small changes —> big effects : Suggestions?
A mother-of-two collapsed and died after having suffered a fatal haemorrhage at a crowded A&E department
The 39-year-old had been waiting for at least seven hours at Queen’s Medical Centre in Nottingham before she was discovered unconscious under a coat.
The woman first attended A&E in the late hours of January 19 complaining of a severe headache.
She was triaged and observed three times by nurses and while her case was escalated, she was not seen by a doctor before being discovered.
—> The first hour after any medical incident is known as the “golden hour”, with the best possible chance of recovery if seen promptly.
Why not move one of the A&E docs out of A&E and into triage as part of triage shift rotation? They will successfully save more lives that way than struggle hours later too late when God himself couldn’t save them. Yes, waiting times might get longer, but deaths and adverse outcomes will be greatly reduced.
Many serious conditions are difficult to assess even for a doctor let alone a receptionist or nurse.
Meningitis looks like flu
Diabetics without insulin appear intoxicated
Stroke victims can also look appear intoxicated
Poison victims can appear well, but have only minutes before their condition becomes irreversible
Patients will be less stressed because they know that they have been assessed by a doctor licensed to practice emergency medicine, and not the receptionist in a bad mood or a nurse neither qualified to diagnose or assess. Both would benefit from not being asked to do what they are not qualified to do.
The A&E docs would benefit because they know they are unlikely to receive as many unrecoverable cases.
Problem 2: Drug interactions & contraindications missed
NHS Patients often suffer serious adverse effects of prescribed medicine when two contraindicated medications are prescribed, one by the hospital, the other by the GP. The prescribing doc is supposed to take a detailed medication history and check contraindications at different dosages (sometimes bad things happen only when two drugs are prescribed at above a certain dosage). These checks often don’t happen because docs are busy or the gp does not know what the hosp has prescribed. They all go through the same NHS prescription system. Why not have the NHS prescription database hold the history and do laborious automatic contraindication checks which it could easily do, as a machine, rather than rely on fallible human docs?
Problem 3. Impossibility of booking or changing bookings on NHS leading to £1bn annual loss (NHS figure).
Why does every NHS hospital, consultant and gp surgery need to invent and waste money on its own uniquely invented run-in-a-silo booking system, when it’s supposed to be a National Health System?
Why not copy the commercial model where money does not come from a bottomless tax payer pocket and has to be earned? HCA has a booking system that works across all their GPs and surgeries, restaurants have OpenTable … Instead of wasting money on separate booking systems that are impossible to change anything on without calling the receptionist secretary of every consultant involved in a procedure, and then blaming patients for an annual £1bn “no-show” loss because the patient has given up trying to contact the hospital to change the booking… This should be a single common system. Some London hospitals have taken the initiative to sign up to “MyChart”, an American patient booking mgmt system, and it’s better than any cooked up by the hospitals individually but this is just that small handful of hospitals. Why is there no effective NHS leadership to use taxpayer money wisely?
Can anyone suggest any more additions?
I want to put these to my hosp patient committee but would like to sound these out here with this community of NHS frequent flyers!
- All Categories
- 2.3K Welcome
- 18 How to use your online community
- 30 Help, Guidelines and Get in Touch
- 40.9K Our Community
- 9.1K Living with arthritis
- 81 Hints and Tips
- 231 Work and financial support
- 724 Chat to our Helpline Team
- 4 Want to Get Involved?
- 393 Young people's community
- 9 Parents of Children with Arthritis
- 43 My Triumphs
- 136 Let's Move
- 26 Sports and Hobbies
- 18 Food and Diet
- 261 Coronavirus (COVID-19)
- 18 Community Feedback and ideas
- 355 Chat and News
- 37 Val's Cafe
- 283 Chit chat
- 11 News
- 4 Tails From The Cafe